Francis W. Price Jr., MD is one of a few doctors in the world to have performed more than 8,000 cornea transplant procedures. In Indianapolis, the doctors of Price Vision Group are actively involved in physician education through their association with the Cornea Research Foundation of America. They have been principal investigators on many research projects dealing with the medical and surgical treatment of corneal disease and disorders. They also participate in lectures at local and national scientific meetings and are acknowledged to be among the leaders in the field of corneal surgery. A number of studies have shown a definite improvement in transplant survival when the surgery is performed in a center that specializes in corneal transplants. Dr. Price and his team of doctors in the clinic are part of one of the busiest and most successful corneal transplant centers in the world. Experience like theirs is unmatched in all but a handful of other centers. This experience will help you have a successful result from your surgery.
The cornea is the clear part in the front of your eye – the window of the eye. It allows light to pass through and come to focus on the retina. The cornea must remain clear to provide good vision. Corneal disease, degeneration and scarring from injury can all cause the cornea to become cloudy and result in decreased vision. If visual decrease is significant, a corneal transplant may be necessary, using a donor cornea or an artificial cornea.
A corneal transplant involves replacing a cloudy cornea with a clear donor cornea.
Donor tissue comes from individuals who have donated their eyes for the benefit of others. The donor is carefully screened for many infections and diseases including hepatitis, syphilis and AIDS. An eye bank network is used to obtain a donor cornea and ensure the safe use of the tissue. All of our corneas come from eye banks in the United States, which are regulated by the FDA.
Descemet membrane endothelial keratoplasty (DMEK) is the most exciting option available to treat the decreased vision and swollen, cloudy corneas seen in Fuchs’ Dystrophy, bullous keratopathy, and other causes of poor corneal endothelial function. DMEK has been shown to offer patients the best chance to see 20/25 or better, resume normal activities quickly, and avoid vision-threatening rejection episodes. This is because DMEK is the most anatomical repair possible – just one cell layer (the endothelial cells) and a thin membrane all of which is only 15 to 20 microns thick.
This is performed when scarring involves the front half of the cornea. Your cornea is dissected in half and the front of it is removed. The new donor cornea is then sewn in place. This procedure is less invasive and your eye will be stronger after surgery than it would be with a regular full thickness transplant. However, there can be some loss of clarity from the interface between the new and remaining layers of the cornea.
Also called deep lamellar endothelial keratoplasty (DLEK), posterior lamellar corneal transplant is performed when the inner cell layer of the cornea has stopped working. Dr. Price has helped pioneer this new surgery as he has sponsored and taught courses to train other doctors from across the country on this new technique. Your cornea is dissected into 2 layers through a small incision on the side of your eye. The donor cornea is also dissected. The back portion of the donor is placed in your eye through the small incision. The natural suction of the cornea holds the new layer in place. A few stitches are then placed to close the small incision.
Your vision may improve faster with this type of transplant compared with a full thickness corneal transplant and there are fewer stitches. Most importantly, the eye is stronger after this type of transplant and less prone to accidental injury. Also, there is usually less astigmatism with this technique compared with a full thickness transplant. In some cases, a special laser might be used prior to transplant surgery to help provide better vision.